Switching specialities

‘I gave up a national training number in a competitive surgical speciality to do histopathology’

In August 2015 I starting training in histopathology at ST1 level. Two weeks earlier I had finished my last shift as an ST4 in vascular surgery at a busy tertiary referral centre. I had done everything ‘right’ as a surgical trainee – I passed my MRCS and got my CT1 and ST3 posts on the first attempt. After two years as a surgical registrar I had become increasingly disillusioned with my career and, in short, had stopped enjoying the job. I started a casual search for possible alternative career options and eventually discovered histopathology, a career I had never previously considered. As a medical student I wasn’t even really sure what pathologists did. However the more I read the more I was drawn to the scientific nature of the job and the analytical mindset required to make accurate and useful diagnoses. I organised taster days and got talking to some of the histopathology trainees. The training they were receiving surpassed anything I had encountered in surgery. They also seemed much more in control of their day to day workload.

Having made up my mind about my radical change of career path I had a meeting with my educational supervisor. He was surprised but incredibly supportive and even helped with my application to histopathology. The other consultants in my unit were also very supportive and many of them were of the opinion that if I had decided at ST4 that I wasn’t enjoying surgery, it wasn’t likely to improve.

My advice for anyone already in speciality training who is unhappy and considering histopathology as a career? It is never too late to change specialities. Histopathology is a 5-6 year training scheme. Weigh that up against 20-30 years of being unhappy in a speciality you don’t want to do anymore. I would recommend some taster days before making any definite decisions, mostly to experience time at a microscope and to get a feel for the very different work environment. Also talk to as many trainee and consultant pathologists as you can – they will each have a different view on the pros and cons of the career. The decision that you’re making is not a small one and it can feel daunting to give up a hard earned NTN, but for me it was the right decision. I’m definitely more satisfied in my new job.

Upon starting my new job I thought I would be alone in coming from a different speciality. However it seems that a large number of histopathology trainees have been surgical or medical registrars prior to their current career. Some had gotten tired of constantly applying for an elusive ST3 post, some had become disillusioned in spite of having an NTN. Others had wanted a better quality of training, job satisfaction and work-life balance. This makes for a great mix of characters amongst pathology trainees.